ARE HEALTH CARE PROCEDURES ALWAYS VALUABLE TO PATIENTS?

Ljubljana, Slovenia – In 2009, the Health Insurance Institute of Slovenia (HIIS) introduced the national tender for health care programs. The goal of the national tender was to increase the access to health care services to patients by introducing price competition among health care providers for defined programs.

Researchers from the Institute for Economic Research in Slovenia measured the gain in health as judged by patients themselves in four health care programs carried out on a national level: hip replacement, hernia surgery, carpal tunnel release, and vein surgery.

The research was performed among different providers in Slovenia who were included in the national tender providing selected health care procedures to the population. The subjective quality of each procedure measured by EQ-5D revealed big differences in the quality among the providers. The results of the study showed the usefulness of health care procedures in impacting the quality of life of patients as judged by patients themselves. Alarmingly, many procedures not only did not enhance the patients’ quality of life, but actually decreased it. More research, including other indicators besides the EQ-5D, is needed to confirm the findings; nevertheless, it is important to always listen to the patients in outcome research.

Based on the results of the linear regression models, researchers Valentina Prevolnik Rupel, PhD, and Marko Ogorevc, PhD, predicted the health-related outcome of optimal patient allocation, as if each patient visited “the best provider.” The best provider was chosen on the basis of the highest regression coefficient for each selected program. Altogether, the effect due to optimal patient allocation was estimated at 0.84 QALY per patient.